Atrial Arrhythmias after Cardiothoracic Surgery

Ommen, Steve R.; Odell, John A.; Stanton, Marshall S.

doi:10.1056/nejm199705153362006

Cited by 400 publications

(244 citation statements)

References 51 publications

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“…Old age, mitral stenosis and atrial manipulation were described as independent factors for development of atrial fibrillation in other studies 5,12 .…”

Section: Discussionmentioning

confidence: 99%

“…The presence of postoperative atrial fibrillation is associated with a higher incidence of complications, such as congestive heart failure, cerebrovascular accidents, renal dysfunction, infections and cognitive disorders 5,13 . These complications increase the length of hospital stay, thereby increasing the hospitalization costs 14,15 .…”

Section: Discussionmentioning

confidence: 99%

“…Atrial arrhythmias are frequent complications in the period after cardiac surgery, affecting from 11 to 40% of patients who undergo myocardial revascularization and 50% of patients who undergo valve replacement Atrial fibrillation is a common arrhythmia in the period after cardiac surgery, which prolongs the use of mechanical ventilation and vasoactive drugs, causing an increase in morbidity and hospitalization time, thereby overloading the health service [3][4][5] . Its pathogenesis is linked to variables such as: age, previous atrial arrhythmia, left ventricular end-diastolic pressure, intraoperative technical factors and inflammatory mechanisms 4,6,7 .…”

Section: Introductionmentioning

confidence: 99%

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Uso crônico e regular de estatina previne fibrilação atrial no pós-operatório de cirurgia cardíaca

Alves¹,

Campos²,

Nakiri³

2010

Arq. Bras. Cardiol.

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“…Old age, mitral stenosis and atrial manipulation were described as independent factors for development of atrial fibrillation in other studies 5,12 .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Uso crônico e regular de estatina previne fibrilação atrial no pós-operatório de cirurgia cardíaca

Alves¹,

Campos²,

Nakiri³

2010

Arq. Bras. Cardiol.

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“…The first mechanism refers to the fact that the dispersion of atrial refractivity is reduced with the use of a biatrial pacemaker. Clinical studies have shown that atrial extrasystoles result from the dispersion of atrial refractivity 5,[24][25][26] . This difference in atrial electrophysiology is essential for the reentry that facilitates the start of atrial fibrillation.…”

Section: Discussionmentioning

confidence: 99%

Influência da estimulação biatrial temporária externa na prevenção da fibrilação atrial no pós-operatório de revascularização miocárdica sem circulação extracorpórea

Silva¹,

Milani²,

Précoma³

et al. 2008

Arq. Bras. Cardiol.

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“…[68][69][70] Temporary epicardial pacemaker wires are routinely implanted during surgery for ventricular pacing in case of postoperative third degree AV-block. In cases of severe intraoperative bradycardia or asystole, temporary atrial pacing may be useful for better haemodynamic stability; an increase in heart rate increases cardiac output if AV synchrony is maintained.…”

mentioning

confidence: 99%

Shock Management For Cardio-Surgical ICU Patients — The Golden Hours

Hauffe¹,

Krüger²,

Béttex³

et al. 2015

Cardiac Failure Review

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Shock in cardio-surgical intensive care unit (ICU) patients is a serious condition with a high morbidity and mortality.1,2 Prompt identification of the underlying conditions and correct management of the lifethreatening physiological deteriorations are crucial to save the patient's life. In daily practice, however, focusing on the main goal -to provide adequate oxygen delivery thereby preventing further organ damage -is often difficult due to multiple influences, distractions, and pending results. Hence, the setting up of priorities is necessary.In addition, many questions arise on how to optimally treat patients in shock: What blood pressure should we target? What fluid should we use and how much? Which vasoactive drug is best and which inotrope? While discussions about these issues can be very fruitful for experts, they risk confusing younger colleagues and nurses at the bedside. Disputes about controversial therapy opinions might consequently delay adequate resuscitation, putting the patient at risk of an adverse outcome. This review aims to give recommendations for the management during the early phase of shock of cardio-surgical patients hospitalised in the ICU. The focus is on the first 6 hours, which are also called 'the golden hours'. Methods Clinical SettingThe cardio-surgical ICU at the University Hospital Zurich is a 12-bed, high-intensity unit that cares for more than 1,100 patients every year.The majority of these critically ill patients undergo cardiac and/or major vascular surgery, most of them being mechanically ventilated and on inotrope/vasopressor support. The unit is part of a successful heart failure programme that includes extracorporeal life support, ventricular assist devices and a heart transplantation service. In order to optimise the initial resuscitation of patients and to avoid adverse effects of inadequate treatment, the consultants of the unit have agreed on treatment recommendations, which are presented here.They are based on current evidence and complemented by clinical experience in areas of uncertainty. Data ExtractionFor this narrative review, a search of the PubMed database and a review of bibliographies from selected articles were performed to identify original data relating to this topic. Key words used for the search were 'shock', 'cardiac surgery', 'critical care', 'inotropes', 'inotropic therapy', 'circulatory support', 'cardiogenic shock' and 'sepsis'. National and international guidelines were reviewed and integrated, e.g. The 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation, 3 The 2014 ESC/ EACTS guidelines on myocardial revascularization 4 and The Surviving Sepsis Campaign guidelines 5 . Articles were scrutinised regarding their study design, population evaluated, interventions, outcomes, and limitations. Finally, personal recommendations were included and highlighted as such to give a comprehensive overview on this topic. Rationale for an Early Management of ShockShock in patients under...

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Atrial Arrhythmias after Cardiothoracic Surgery

Cited by 400 publications

References 51 publications

Uso crônico e regular de estatina previne fibrilação atrial no pós-operatório de cirurgia cardíaca

Uso crônico e regular de estatina previne fibrilação atrial no pós-operatório de cirurgia cardíaca

Influência da estimulação biatrial temporária externa na prevenção da fibrilação atrial no pós-operatório de revascularização miocárdica sem circulação extracorpórea

Shock Management For Cardio-Surgical ICU Patients — The Golden Hours

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